REVENUE ACCOUNTANT

PSN Services LLC•Plano, TX

About The Position

The Revenue Accountant serves as a key member of the Finance and Accounting team, responsible for ensuring the accuracy, completeness, and timeliness of revenue recognition across Legent Health’s multi-facility platform. This role functions as the critical bridge between Revenue Cycle Management (RCM) operations and GAAP financial reporting, translating case-level billing data into auditable financial statements. The initial focus of this position is healthcare revenue recognition, contractual allowance analysis, and direct collaboration with RCM leadership. Over time, the role will expand to include incremental general accounting responsibilities, providing a well-rounded career development path within a high-growth, PE-backed platform.

Requirements

Bachelor’s degree in Accounting, Finance, or closely related field (required).
3–5 years of progressive accounting experience (required).
Minimum 1–2 years of healthcare accounting experience, preferably in ambulatory surgery centers, surgical hospitals, or multi-site provider organizations (strongly preferred).
Experience with healthcare revenue recognition, contractual allowance analysis, and payer reimbursement methodologies (strongly preferred).
Strong understanding of ASC 606 revenue recognition principles as applied to healthcare entities.
Working knowledge of managed care contracting, payer reimbursement methodologies (APC/OPPS, DRG, case rates, percent-of-charge), and the healthcare revenue cycle from scheduling through collections.
Analytical mindset with the ability to identify trends, anomalies, and root causes in large data sets.
Excellent communication skills with the ability to collaborate effectively across finance, RCM, and operations teams.
Attention to detail, strong organizational skills, and the ability to manage multiple priorities in a fast-paced, high-growth environment.
Self-starter mentality with a continuous improvement orientation
Sage Intacct – General ledger, multi-entity management, and dimensional reporting (required).
Microsoft Power BI – Dashboard development, data visualization, and report creation (required).
Advanced Microsoft Excel – Complex formulas, pivot tables, VLOOKUP/INDEX-MATCH, and data modeling (required).

Nice To Haves

Master’s degree in Accounting, Finance, or MBA (preferred).
CPA License or CPA candidate (preferred).
HFMA Certified Healthcare Financial Professional (CHFP) or Certified Specialist in Accounting and Finance (CSAF) (preferred).
Minimum 1–2 years of healthcare accounting experience, preferably in ambulatory surgery centers, surgical hospitals, or multi-site provider organizations (strongly preferred).
Experience with healthcare revenue recognition, contractual allowance analysis, and payer reimbursement methodologies (strongly preferred).
HST Pathways – Surgical scheduling, billing, and case-level data extraction (strongly preferred).
CPSI (TruBridge) – Patient accounting and revenue cycle modules (preferred).

Responsibilities

Prepare and post monthly net patient service revenue journal entries for all facilities, including gross charges, contractual adjustments, implicit price concessions, and third-party payer settlement reserves.
Calculate and validate contractual allowance percentages by payer, plan, and facility; perform monthly variance analysis comparing estimated versus actual reimbursement rates.
Perform implicit price concession analysis using historical collection patterns, AR aging data, and payer mix trends; execute quarterly hindsight reviews to validate estimation methodology.
Prepare revenue disaggregation schedules by payer type, service line, facility, and geography in accordance with ASC 606 disclosure requirements.
Analyze case-level revenue by facility, payer, and specialty to support operational decision-making, facility-level profitability analysis, and PE reporting requirements.
Monitor and reconcile high-cost implant billing and reimbursement, including supply and implant cost tie-outs to case-level revenue.
Serve as the primary accounting liaison to the RCM team, participating in weekly cross-functional meetings to review AR aging trends, denial patterns, cash application variances, and payer mix shifts.
Reconcile patient accounting system AR subledger to the general ledger on a monthly basis; investigate and resolve discrepancies between RCM billing data and financial records.
Perform three-way reconciliation between patient accounting system AR, GL AR, and bank deposits to ensure completeness and accuracy of cash posting.
Validate charge capture completeness by reconciling surgical case counts in HST to charges posted in the billing system; flag discrepancies for timely resolution.
Track and report key revenue cycle performance metrics including Days Sales Outstanding (DSO), clean claim rate, denial rate, net collection rate, and Days in DNFB.
Support the monthly close process within established timelines, with specific ownership of revenue-related journal entries, reconciliations, and supporting schedules.
Prepare and maintain balance sheet account reconciliations for accounts receivable, contractual allowance reserves, bad debt reserves, and third-party settlement accruals.
Develop and maintain Power BI dashboards and reports for revenue cycle KPIs, payer mix analysis, and DSO trending by facility.
Assist in the preparation of monthly financial reporting packages, including variance commentary for revenue-related line items.
Support external audit, quality of earnings, and due diligence requests by preparing revenue-related schedules, analyses, and documentation.
Over time, assume additional general accounting duties including expense accruals, intercompany transactions, and facility-level P&L preparation as the team scales.
Participate in acquisition integration activities, including chart of accounts mapping, opening balance sheet preparation, and onboarding new facilities to Sage Intacct.
Contribute to process improvement initiatives aimed at reducing the month-end close cycle and enhancing reporting accuracy and efficiency.
Support budget and forecast processes by providing revenue-related assumptions, historical trend data, and payer rate analysis.